How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $46.77 | Professional | None | $44.67 | $46.77 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $181.97 | Facility | None | $75.86 | $95.50 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $46.77 | Professional | None | $42.66 | $42.66 | $46.77 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $4.68 | Professional | RR · Rental | $4.27 | $4.27 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $35.48 | Professional | UE · Used equipment | $31.62 | $31.62 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $47.86 | Facility | None | $43.65 | $43.65 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | None | $31.62 | $31.62 | $43.65 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $29.51 Median $66.07 Typical High $87.10 | Professional | None | $29.51 | $66.07 | $87.10 |
Martin's Point Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $46.77 | Professional | None | $44.67 | $46.77 | $46.77 |
United Setting Professional Modifier None Typical Low $29.51 Median $38.02 Typical High $104.71 | Professional | None | $29.51 | $38.02 | $104.71 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $21.88 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $8.91 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.61 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.47 | $4.68 | $4.68 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $21.88 | $22.91 | $22.91 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $8.91 | $9.33 | $9.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.61 | $6.92 | $6.92 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.47 | $4.68 | $4.68 |
Where Maine sits
The same service costs 2.6 times more in Montana than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maine· 31st of 51
$42.66
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.